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For Care at UChicago Medicine

Expert Care for Facial Paralysis

The University of Chicago Medicine’s specialized team of physicians, surgeons and rehabilitation experts work together to diagnose and treat facial nerve paralysis. Our team includes plastic surgeons, neurologists, ophthalmologists, neurotologists (doctors who specialize in conditions affecting nerves in the head and neck), oculoplastic surgeons and physical therapists. We all work together to offer the best treatment plan for each individual patient.

What is Facial Paralysis?

Facial nerve paralysis is a common condition that can affect people of all ages. It usually occurs when the nerve that carries electrical signals from the brain to the face is damaged. When that happens, a person is unable to control the muscles on the affected side of the face. This affects the apperance of the face at rest, as well as a person's ability to use facial expressions to convey emotion, protect the eyes and perform daily functions like eating and speaking.

Sometimes facial nerve paralysis develops very quickly and goes away without much intervention — common with a condition called Bell's palsy. However, there may be residual facial asymmetry or synkinesis (facial muscles moving together involuntarily) even after the facial nerve recovers. In other instances, the nerve may be permanently damaged and require surgery.

Treating Facial Paralysis

Our experts offer a variety of non-surgical and surgical treatments to restore facial function in patients with facial nerve paralysis. Our team will work closely with you to pick a therapy that fits your needs; however facial nerves take some time to heal. It may take months to see a final result.

We offer the following treatment options:

Nonsurgical Treatments

Facial paralysis is often temporary. In these cases, certain medications may help with recovery, if they are administered early enough. Additionally, it is very important to protect the eyes during an episode of facial paralysis to prevent damage. Our ophthalmologists can offer various nonsurgical methods to help.

Our occupational therapists work with patients to retrain their facial muscles after an episode of temporary facial paralysis, especially when synkinesis develops. Additionally, they work with patients who require surgery, helping them retrain their facial movements after an operation.

Some patients may have subtle facial asymmetries after an episode of facial paralysis. Our plastic surgeons offer various nonsurgical options, such as Botox and fillers, to help rebalance the face. Botox can also be helpful to treat synkinesis.

Surgical Treatments

Static

Static procedures can restore a symmetrical look to the face at rest, help with vision obstruction, provide protection to the eye and help with oral competence or drooling.

Brow procedures help restore symmetry and lessen vision problems caused by brow obstruction. In many cases, our surgeons can hide the scar in the natural wrinkles of your forehead or in your brow or hairline. This may be done with endoscopic techniques, which leave minimal scarring.

Eyelid procedures help prevent dry eye and protect the eye from injury. Some patients many have a small gold or platinum weight implanted in the upper eyelid to help the eyelid close. There are also lower eyelid-tightening procedures that can help with appearance and symptoms.

Lack of tone around the mouth can make it difficult to keep food and fluids in the mouth. It can also cause drooling. Patients may benefit from a static fascial sling, which helps pull the corner of the mouth into a higher, tighter position.

Dynamic

In some cases, when the facial nerve needs to be removed during cancer treatment or it was damaged from trauma, surgeons can immediately bridge the nerve gap with other nerves from your body. Over time, you will regain facial function after the nerve has regenerated.

Facial muscles remain healthy for about 18 months before they begin to atrophy due to lack of use. During that time, you may be a candidate for a procedure that redirects functioning nerves on your face to the healthy muscle. This may involve using healthy nerves with redundant function in other parts of your body, such as the neck or leg.

In situations where the facial muscles are either damaged from surgery, trauma or radiation, or where the muscles have been without a functioning nerve for too long, you may be a candidate for a functional muscle transfer. During functional muscle transfer, healthy muscle is brought to the face to help restore your smile.

Common options for functional muscle transfer surgery include:

Temporalis muscle transfer (Labbe procedure). This surgery uses a muscle you normally use to chew and reroutes it to help you smile on the paralyzed side when you clench your jaw.

Free functional gracilis transfer. This surgery takes an extra muscle from your thigh and moves it to your face, where it is then connected to blood vessels and nerves to help restore your smile.